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    <title>老货司机</title>
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    <meta name="description" content="老货司机,您身边的司机保险专家" />
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</head>

<body>
<div class="container hide" id="mainContainer">
    <div class="main scroller" id="wrapper">
        <div class="inner">
            <form action="" method="get" accept-charset="utf-8" id="applyForm">
            <!-- 投保人信息 开始 -->
            <div class="box">
                <div class="box-hd">
                    <h3>投保人信息</h3>
                </div>
                <div class="box-bd">
                    <div class="form-group">
                        <input type="hidden" name="productNo" value="1416c49773a6a0980e5f00943756b31377ea701f4c6b">
                        <div class="input-row input-row-label input-x-right">
                            <label for="">姓名</label>
                            <input type="text" name="holderName" class="input-controll" placeholder="必填" onblur="validate(value, 'require cnName', '请输入正确的姓名')" value="王中山">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">证件类型</label>
                            <div class="input-sel" id="holder-cert-type">统一社会信用代码</div>
                            <input type="hidden" name="holderCertType" value="TY">
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">证件号码</label>
                            <input type="number" class="input-controll" name="holderCertNo" placeholder="请输入证件号码" value="410602198903214511" oninput="if(value.length>18)value=value.slice(0,18)" onblur="validate(value, 'require certNum', '请输入正确的证件号码')">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">电子邮件</label>
                            <input type="text" class="input-controll" name="holderEmail" placeholder="必填" value="291518@qq.com" onblur="validate(value, 'require email', '请输入正确的电子邮件地址')">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">手机号码</label>
                            <input type="tel" class="input-controll" name="holderTel" placeholder="必填" value="18116456783" onblur="validate(value, 'require mbNum', '请输入正确的手机号码')">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                    </div>
                </div>
            </div>
            <!-- 投保人信息 结束 -->

            <!-- 被保险人信息 开始 -->
            <div class="box">
                <div class="box-hd">
                    <h3>被保险人信息</h3>
                </div>
                <div class="box-bd">
                    <div class="form-group">
                        <div class="input-row input-row-label input-x-right">
                            <label for="">被保险人名称</label>
                            <input type="text" class="input-controll" name="insureName" placeholder="与行驶证上所有人名称一致" value="小鱼儿" onblur="validate(value, 'require cnName', '请输入正确的姓名')">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">证件类型</label>
                            <div class="input-sel" id="insure-cert-type">统一社会信用代码</div>
                            <input type="hidden" name="insureCertType" value="TY">
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">证件号码</label>
                            <input type="number" class="input-controll" name="insureCertNo" placeholder="请输入证件号码" value="410602198703214511" oninput="if(value.length>18)value=value.slice(0,18)" onblur="validate(value, 'require certNum', '请输入正确的证件号码')">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                    </div>
                </div>
            </div>
            <!-- 被保险人信息 结束 -->

            <!-- 投保信息 开始 -->
            <div class="box">
                <div class="box-hd">
                    <h3>投保信息</h3>
                </div>
                <div class="box-bd">
                    <div class="form-group">
                        <div class="input-row input-row-label input-x-right">
                            <label for="">车辆牌照号</label>
                            <input type="text" class="input-controll" name="transNo" placeholder="必填" value="鲁F23435" onblur="validate(value, 'require vehicleNum', '请输入正确的车辆牌照号')">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">挂车车牌号</label>
                            <input type="text" class="input-controll" name="trailerNo" placeholder="必填" value="挂A243452" onblur="validate(value, 'require vehicleGNum', '请输入正确的挂车车牌号')">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">单号</label>
                            <input type="text" class="input-controll" name="freightNo" placeholder="发票号/提单号/运单号" value="342435353536" onblur="validate(value, 'require', '请输入正确的单号')">
                            <span class="input-x" style="display:none;"></span>
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">起运日期</label>
                            <input type="text" class="input-controll" name="expectStartTime" placeholder="起运日期" id="date-calendar">
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">起运地</label>
                            <div class="input-sel" id="departureAreaSel">上海市</div>
                            <input type="hidden" name="departurePlace">
                        </div>
                        <div class="input-row input-row-label input-x-right">
                            <label for="">目的地</label>
                            <div class="input-sel" id="destinationAreaSel">湖南省</div>
                            <input type="hidden" name="destinationPlace">
                        </div>
                    </div>

                </div>
            </div>
            <!-- 投保信息 结束 -->

            <!-- 是否显示费率及保费 开始 -->
            <div class="box">
                <div class="box-hd">
                    <h3>在电子保单中是否展示费率及保费</h3>
                </div>
                <div class="box-bd">
                    <div class="form-group radio-single-wrap">
                        <ul class="radio-group radio-single clearfix">
                            <li class="radio-handle"><em class="radio radio-on">展示</em></li>
                            <li class="radio-handle"><em class="radio">不展示</em></li>
                        </ul>
                        <input type="hidden" name="isShowPremium" value="Y">
                    </div>
                </div>
            </div>
            <!-- 是否显示费率及保费 结束 -->

            <!-- 保单信息 开始 -->
            <div class="box">
                <div class="box-hd">
                    <h3>保单信息</h3>
                </div>
                <div class="box-bd">
                    <div class="form-group">
                        <div class="input-row input-row-label input-x-right">
                            <label for="">保额</label>
                            <div class="input-val"><span>100万</span>元</div>
                            <input type="hidden" name="coverage" value="1000000">
                        </div>
                    </div>
                </div>
            </div>
            <!-- 保单信息 结束 -->

            <div class="btnbar">
                <input type="submit" class="btn btn-primary btn-block" value="下一步">
            </div>
            </form>

            <div class="blank-line clearfix">&nbsp;</div>
        </div>
    </div>
</div>

<div class="cover">
    <div class="popup"></div>
</div>

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$('#applyForm').submit(function(){
    var form = $('#applyForm');
    var formData = form.serialize();
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    $.ajax({
        url: API_HOST + '/Product/apply',
        type: 'POST',
        dataType: 'json',
        data: formData
    })
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        console.log(res)
    })

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